Incontinence

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11 07, 2012
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Urinary Incontinence

Urinary incontinence is the loss of bladder control, ranging from occasional minor leaking when coughing or sneezing to sudden, strong urges that don’t allow time to get to a toilet.  An embarrassing problem, urinary incontinence is actually very common.
Common causes:
  • Aging 
  • Underlying medical conditions such as urinary tract infections, constipation, or neurological disorders (Parkinson’s disease, multiple sclerosis, stroke, a brain tumor or a spinal injury)
  • In women, urinary incontinence may occur following pregnancy, childbirth, hysterectomy, and menopause
  • In men, urinary incontinence may occur with problems or removal of the prostate gland
There are different types of urinary incontinence:
  • Stress incontinence occurs when pressure or stress is exerted on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy and is due to the sphincter muscle of the bladder being weak. 
  • Urge incontinence is a sudden, intense urge to urinate, followed by an involuntary loss of urine, often causing frequent urination.  Urge incontinence may be caused by urinary tract infections, bladder irritants, bowel problems, neurological disorders or in some cases, the cause isn’t known. 
  • Overflow incontinence is an inability to empty the bladder causing frequent or constant dribbling. This type of incontinence may occur in people with a damaged bladder, blocked urethra or nerve damage.
With urinary incontinence, there usually is an issue with the pelvic floor muscles being either too weak to stop the flow of urine, or too tense and unable to relax, causing them to give out suddenly. Conventional treatment may involve exercises to strengthen or retrain these muscles in order to improve functioning.
Acupuncture can also help to stimulate the muscles in order to strengthen them and encourage proper functioning, thereby improving urinary incontinence. However, an acupuncturist also takes the treatment one step further, to look at the underlying health factors in the body that may be causing these muscles to function poorly or improperly. This is particularly the case with chronic conditions or internal problems that take time to develop- an internal problem over time will lead to the development of outward symptoms.In Chinese medicine, there are a number of factors that may lead to urinary incontinence.  Urinary incontinence typically involves the body’s energy being weak or deficient in one of the meridian systems that are responsible for the body’s proper functions. 
  • Lung-qi deficiency will involve frequent urge to urinate with inability to contain it, as well as dribbling when coughing or sneezing, and other symptoms of tiredness, shortness of breath, and weak voice. 
  • Spleen-qi deficiency involves incontinence with urgency, frequent urges and inability to contain it, as well as loose stools, tiredness, and poor appetite. 
  • Kidney-yang deficiency involves frequent urination, dribbling, exhaustion, dizziness, tinnitus, weak and sore back and knees, and feeling cold, and is often the case with incontinence in the elderly. 
  • Kidney-yin deficiency involves incontinence with dribbling after urination, dark urine, dry throat, dizziness, tinnitus, night sweats, and insomnia.
Acupuncture encourages healthy functioning of the body’s various systems, to ensure that all aspects of the urinary system are performing properly. Over a series of treatments, this allows us to not only treat the symptoms of urinary incontinence, but also correct the underlying factors that are causing this problem. In addition, other symptoms such as sleep, energy, and digestion may also improve, as these are common outward expressions of internal imbalances that we often don’t realize are related. In this way, acupuncture can have a very positive impact on overall quality of life.
Lifestyle habits that can help with an incontinence problem:
  • Avoiding alcohol, caffeine or other diuretics, as well as carbonated drinks
  • Avoiding very spicy, sugary, or acidic foods, artificial sweeteners, and corn syrup, all of which can aggravate the bladder
  • Certain medications including those for heart, blood pressure or muscle relaxants can also contribute to bladder problems.
James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, downtown Kelowna. He can be reached at www.okanaganacupuncture.com.

6 03, 2012

Bed-Wetting

Bed-wetting, or involuntary nighttime urination, is a common occurrence for many children. It’s often simply a developmental stage, though an embarrassing one. It is most common for children under the age of 6 or 7, and most will outgrow it beyond this age. Between ages 8 and 11, fewer than 5% of children continue to have a problem with bed-wetting. It’s generally not a cause for concern because nighttime bladder control may not yet be established.

It’s not clear what causes bed-wetting, but there may be various factors, including a small bladder, inability to recognize a full bladder, hormonal imbalance, stress, sleep apnea,  chronic constipation, urinary tract infection, diabetes, or in rare cases an anatomical defect in the neurological or urinary system. Most children outgrow bed-wetting on their own. However, for more difficult cases, treatment may include using moisture alarms, bladder training, or if all else fails, medications.

Of course, many parents are not comfortable with the use of medications for their children. This is where Chinese medicine (TCM) can help. Children are not miniature adults, but have their own special health considerations. Their anatomy and physiology are immature, so treatments used for adults may not be appropriate for a child’s delicate system. Also, because children are generally quite healthy and quick to heal, they respond very quickly to treatment and require lighter treatment than adults. When using acupuncture, this means fewer points, gentler treatment, and fewer sessions to resolve the problem. Also, simple home remedies such as acupressure and diet or lifestyle changes may be enough to resolve the issue.

In Chinese medicine, bed-wetting is mainly due to the immaturity of the kidneys. Because the kidneys are responsible for urination and the bladder’s retention, it follows that a child’s not yet fully developed kidneys may lead to urinary problems. If bed-wetting is due to weak kidneys, it will involve nighttime enuresis of 1, 2 or more times per night, clear urination, pale complexion, lower back or knee soreness or weakness, and possibly cold limbs and an aversion to cold. Bed-wetting may also be due to a weakness in the spleen and lung organ-meridians, in which case the symptoms will involve nighttime enuresis, shortness of breath, white face, weak appetite, loose stools, spontaneous perspiration, lack of strength, and a dispirited nature.

Treatment for bed-wetting is straightforward once the correct cause is determined. Acupuncture can help to strengthen the organs and correct imbalances. But how do you know if acupuncture is appropriate for your child? I always ask parents to discuss acupuncture with their child beforehand, to find out if the child is open to trying it. With their naturally curious nature, most children find the experience to be very positive and do very well in treatment. However, if there is any fear or apprehension, it’s best to leave the idea of acupuncture alone, at least for the time being. With children or with adults, it’s no fun for either patient or practitioner if the person does not want to be there in the first place!

There are simple habits that can be performed at home to help resolve bed-wetting. Patience and understanding are essential, as fear or stress will only further damage the kidneys and aggravate the problem. Avoiding drinking too much in the evening and emptying the bladder before bed is good prevention. Also, the child should not be allowed to become too fatigued before going to bed, as overfatigue can further weaken the kidneys, spleen and lungs. Lastly, a healthy diet without too many rich, greasy, spicy or strong flavours and avoiding chilled or cold food and too much sugar and sweets can also help to strengthen these organs.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.

8 10, 2010

Frequent Urination

Frequent urination can have wide-ranging causes, whether due to a medical condition such as diabetes or a neurological disorder, or from poor kidney function, urinary tract inflammation, bladder infection, or certain medications. In many cases, doctors are unable to exactly identify what’s causing this symptom but nonetheless it can be an uncomfortable and difficult problem to live with.

Frequent or urgent urination in Chinese Medicine (TCM) is most commonly caused by two things. One cause is considered an excess pattern, and the other a deficiency pattern. The excess pattern is that of dampness and heat accumulating in the bladder. Damp-heat can be brought on by a number of reasons, but the biggest reason is poor diet from over-intake of greasy or rich foods, dairy, or hot, spicy foods. Another reason for damp-heat is poor digestion due to a weak spleen and stomach, which can again be caused by poor dietary habits that over time weaken the digestive system.

When dampness accumulates it tends to do so in the lower abdomen where it then stagnates and creates heat or inflammation. If this damp-heat accumulates in the bladder it causes symptoms such as frequent urination with urgency, burning pain on urination, and scanty, yellow, cloudy urine. In Western medicine, this translates into a bladder infection.

The deficiency pattern is due to kidney yang deficiency. The kidneys’ yang energy is responsible for warming and transporting of fluid in the lower abdomen, as well as supplying the bladder with enough energy to contain the urine. Symptoms due to the kidney yang failing to contain urine can include copious clear urine, nighttime urination, lack of warmth in the hands and feet, dizziness, tinnitus and aching low back and knees.

Acupuncture can help strengthen the body to decrease the frequency of urination in many cases. However, in the case of damp-heat in the bladder, stronger treatment is required due to the nature of the problem being an infection, and a visit to your doctor is recommended. In this case acupuncture can be helpful in preventing future bladder infections in people who are prone to them. Acupuncture can help to strengthen a weak spleen and stomach and to clear problems of damp and heat in the bladder that typically lead to bladder infections. This is a good example of how an imbalance in the body can give rise to other health issues, the cause of which may not always be evident.

Acupuncture can be very beneficial in correcting any imbalances in the body that may be impeding optimal health, making acupuncture a very effective treatment method for a wide range of health concerns.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.